Healthcare Provider Details

I. General information

NPI: 1760440838
Provider Name (Legal Business Name): KAREN H ROSENBAUM LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 CONWAY ST GREENFIELD HEALTH CENTER
GREENFIELD MA
01301-1526
US

IV. Provider business mailing address

PO BOX 8019
SPRINGFIELD MA
01102-8000
US

V. Phone/Fax

Practice location:
  • Phone: 413-774-6301
  • Fax: 413-774-6528
Mailing address:
  • Phone: 866-431-4077
  • Fax: 413-774-7448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number110941
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: